title: Clinical predictors of early death in acute myocardial infarction. A prospective study of 233 patients.
abstract: Patients who suffer acute myocardial infarction are heterogeneous and prognosis differs widely. High-risk patients are likely to derive the greatest benefit from treatment in an intensive care unit and from early thrombolytic therapy. A study was undertaken to determine those clinical parameters, available on admission to hospital, which would predict early death (within the first 30 days) and in this way to define high-risk patients. From July 1985 to December 1987, 233 patients admitted to J. G. Strijdom Hospital with acute myocardial infarction were prospectively evaluated. A total of 30 variables, including clinical, ECG and biochemical parameters, were recorded for each patient on admission. During the study period 36 patients (15.5%) died. The following variables were significantly associated with early mortality: age, Killip class, infarct location, height of ST-segment elevation and raised blood urea level. Using data readily available on admission to hospital, patients at highest risk of early death can be identified.
authors.affiliation: Department of Medicine, J.G. Strijdom Hospital, Johannesburg.
authors.forename: P E
authors.initials: PE
authors.lastname: Marik
authors.forename: J
authors.initials: J
authors.lastname: Lipman
authors.forename: I J
authors.initials: IJ
authors.lastname: Eidelman
authors.forename: P J
authors.initials: PJ
authors.lastname: Erskine
mesh_terms: D000367:Age Factors; D003325:Coronary Care Units; D004562:Electrocardiography; D006801:Humans; D009203:Myocardial Infarction / Q000401:mortality*; D010343:Patient Admission; D011379:Prognosis; D011446:Prospective Studies; D014218:Triage; D014508:Urea / Q000097:blood
chemical_list: D014508:Urea